• Evaluating unmet needs in patients undergoing surgery for colorectal cancer: A patient reported outcome measures (PROMS) study.

      Sutton, P A; Bourdon-Pierre, R; Smith, C; Appleton, N; Lightfoot, T; Gabriel, C; Richards, B; Mohamed, S; Mason-Whitehead, E; Hulbert-Williams, N J; Vimalachandran, D (2019-03-03)
      Patient reported outcome measures (PROMs) are self-reported measures of patients' health status or health related quality of life at a single point in time. We aimed to evaluate the use of a colorectal PROM, and conducted a focus group to further explore this and other unmet needs in our patient population treated surgically for colorectal cancer. A multidisciplinary research group consisting of colorectal surgeons, nurse specialists, psychologists, sociologists and patient representatives devised a composite tool of new and existing outcome measures which was piloted in our local population (n=35). Participants were subsequently invited to attend a semi-structured focus group during which the PROM was reviewed and an unmet needs analysis performed. Thematic analysis of focus group transcripts was undertaken for emergent themes. Initial consensus was for a tool including the EQ-5D, FACT-C, the distress thermometer, a validated measure of stigma, an unmet needs analysis, and questions assessing the psychological impact of cancer. Median and IQR values suggested all metrics were discriminatory with the exception of FACT-C. All participants agreed the tool was acceptable, and reflected the current state of their health and emotions. Thematic analysis of focus group transcripts identified four major themes: Physical symptoms, emotional response, information provision and coping mechanisms. Through expert consensus, local piloting and patient focus groups we have evaluated a novel PROM for colorectal cancer. Furthermore, through our direct engagement with patients we have identified several unmet needs which we are currently exploring within the clinical service. This article is protected by copyright. All rights reserved. [Abstract copyright: This article is protected by copyright. All rights reserved.]
    • Defence Committee: Armed Forces and Veterans Mental Health Inquiry. Part Two. The Provision of Care

      Finnegan, Alan; University of Chester; University of Northumbria (Crown, 2018-09-11)
      Executive Summary * Effective Military Mental Health care requires practitioners with extensive knowledge of service provision and structures, and who have the correct clinical competencies that are underpinned by academic qualification/s and experience. * Veterans are a heterogeneous group, differing by factors such as age, gender and length of service. These factors are extremely important during transition, and initiatives to support ex-Service personnel and their families are hindered through a lack of understanding of the veteran community. * NHS Mental Health care provision is extensive and comprehensive, although is areas such as Northern Ireland, it is Combat Stress that provide bespoke veteran care options, funded through charitable contributions. * Many veterans are unaware of their entitlement to priority medical services, or the wider provisions available to them. * Veterans are unwilling to disclose problems associated with their former military life, often believing that civilians, including healthcare professionals, do not appreciate military culture and “cannot understand” their experiences. * Receiving quick, appropriate support requires GPs and other healthcare professionals having sufficient awareness of the NHS and veteran specific services, and on the patients MH condition being correctly identified. * Stressors identified during the transition period are just as likely to negatively impact on the spouse and family. * There is an assumption that the small local veteran charities may be doing harm, although there is limited evidence to substantiate this view, and there is a requirement to understand why some veterans prefer this option
    • Defence Committee: Armed Forces and Veterans Mental Health Inquiry. Part One

      Kiernan, Matthew; Finnegan, Alan; Hill, Mick; University of Northumbria (Crown, 2018-07-12)
      Executive Summary • MoD provides an occupational military mental health service, where clinical decisions are safety critical due to the environment in which armed forces personnel operate. • Statistics provided from defense are accurate, however, trying to contextualise them by comparing them with the wider population is problematic, as the threshold for referral is much lower. • Only 8% of UK veterans were correctly registered at a PHC practice. • Military mental health practice is unique, and to understand the issues facing current service provision, the statistical data needs to be annually supplemented with purposeful qualitative data from those working in defence mental health. • A priority should be afforded to the inclusion of veteran peer researchers within studies to improve sample selection, interpretation and understanding of results. • There needs to be an agenda to broaden methodological expertise and cooperation within the sector and a move away from a predominately one-dimensional research approach. The only way that the questions in this enquiry will be answered, is through a multiple methods and multiple institution collaboration.
    • Working through interpreters in old age psychiatry: a literature review

      Farooq, Saeed; Kingston, Paul; Regan, Jemma; University of Chester; Staffordshire University (Emerald, 2015)
      Purpose – The purpose of this paper is to systematically appraise the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health. Design/methodology/approach – The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors found in previous reviews that a substantial number of papers from developing and non-English speaking countries are published in journals not indexed in mainstream databases, and devised a search strategy using Google which identified a number of papers, which could not be found when the search was limited to scientific data bases only (Farooq et al., 2009). The strategy was considered especially important for this review which focuses on communication across many different languages. Thus, the authors conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. The authors also searched the reference lists of included and excluded studies for additional relevant papers. Bibliographies of systematic review articles published in the last five years were also examined to identify pertinent studies. Findings – Only four publications related specifically to “old age” and 33 addressed “interpreting” and “psychiatry” generally. Four articles presented original research (Parnes and Westfall, 2003; Hasset and George, 2002; Sadavoy et al., 2004; Van de Mieroop et al., 2012). One article (Shah, 1997) reports an “anecdotal descriptive account” of interviewing elderly people from ethnic backgrounds in a psychogeriatric service in Melbourne and does not report any data. Therefore, only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. One is a quantitative study from Australia (Hasset and George, 2002), the second is a qualitative study from Canada (Sadavoy et al., 2004), in the third paper Van de Mieroop et al. (2012) describe community interpreting in a Belgian old home and the final paper is an American case study (Parnes and Westfall, 2003). Practical implications – Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics. Social implications – The literature on working through interpreters is limited to a few empirical studies. This has serious consequences for service users such as lack of trust in services, clinical errors and neglect of human rights. Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK, unlike Sweden (see www.regeringen.se/sb/d/3288/a/19564). This omission is disturbing – especially when decisions on human rights are being considered as part of the Mental Health Act. Such a standard can best be achieved by collaboration between medical profession and linguists’ professional associations (Cambridge et al., 2012). Originality/value – Whilst translation/interpretation has been addressed more generally in mental health: specific considerations related to old age psychiatry are almost absent. This needs urgent rectification given that a large proportion of older people from BME communities will require translation and interpretation services.
    • Some ethical limitations of privatising and marketizing social care and social work pro-vision in England for children and young people

      Carey, Malcolm; University of Chester (Taylor and Francis, 2019-03-01)
      This article analyses the negative ethical impact of privatisation, alongside the ongoing mar-ketisation of social care and social work provision for children and young people in England. It critically appraises the implications of a market-based formal social care system, which in-cludes the risk-averse and often detached role of social workers within ever more fragmented sectors of care. Analysis begins with a discussion of background policy and context. The ten-dency towards ‘service user’ objectification and commodification are then detailed, followed by a discussion of the limiting of choice for service users. Service and social fragmentation, and the often severely restricted ‘life chances’ of many children and young people in care, are then deliberated. The concluding discussion reiterates the moral implications of marketisation in relation to ethical frameworks, including those associated with autonomy, informed choice, social exclusion and social justice. The tendency towards children increasingly being utilised as a means to an end within business-orientated sectors of care is highlighted, alongside ethi-cal questions asked about the State’s purpose in providing a community of support.
    • Workplace Health and Well-Being

      Massey, Alan; University of Chester (Springer Nature, 2019-09-06)
      The problems related to the process of industrialisation such as biodiversity depletion, climate change and a worsening of health and living conditions, especially but not only in developing countries, intensify. This chapter looks at the role of workplaces in the drive for global sustainability through the World Health Organisations healthy workplace framework
    • Social Work Students’ Perceptions of Ageing

      Ridgway, Victoria; University of Chester (Taylor and Francis, 2018-06-23)
      Little is understood about social work students or social workers’ perceptions of ageing in the UK. This paper presents a small-scale study of 20 master social work students’ perceptions of ageing during the first year of their programme. A mixed method approach was employed over a two-staged research project, in both stages the social work students were asked to complete Kogan’s (1961) Attitudes Towards Older People Scale (KATOPS) and draw a person aged 75. Results demonstrated that most students had neutral to positive attitudes towards older people at the beginning of the programme and these improved in stage two; all had positive attitudes. The drawings provided a visual narrative of their perceptions of older people, visual signifiers included physical signs of ageing. Fulfilment, emotion, family, individuality and appearance were emergent themes. Whilst the programme enhanced the students’ perceptions more work is needed to dispel the myths and stereotypes about ageing
    • Understanding Blogging Motivations in Palliative Care Using Maslow’s Hierarchy of Needs.

      Ngwenya, Nothando; Kingston, Paul; Mills, Stella; Africa Health Research Institute, KwaZulu Natal, South Africa; University of Chester; Staffordshire University (Inderscience, 2018-09-24)
      The pervasive use and potential of weblogs has increased the field of social health informatics and is becoming increasingly difficult to ignore. The prevalence of these technologies for narrative use brings about the fusion of diverse schools of thought on motivation. One proven model is that of Maslow, whose theory of needs has an intuitive appeal in understanding bloggers’ needs and motivations. This paper considers theoretical and practical blogging experiences for palliative care users through the embracement of Maslow’s hierarchy of needs. Palliative care patients, carers and clinicians were interviewed about their weblogs and data qualitatively analysed. The results indicate that the experience of maintaining a weblog is therapeutic for individuals and fulfils needs hierarchically from the lowest to the highest as outlined in Maslow’s theory.
    • Stigma: a linguistic analysis of the UK red-top tabloids press’s representation of schizophrenia

      Bowen, Matt; Kinderman, Peter; Cooke, Anne; University of Chester; Liverpool University; Canterbury University (SAGE publications, 2019)
      Aims. Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods. Using corpus linguistic methods, a sample of newspaper articles over a 24 month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, whilst supported by statistical tests (Log-Likelihood) to compare the data sets and identify words with a high relative frequency. Results. Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. “schizo”) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to: acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency (n=108) and most commonly to name individuals who had committed acts of violence. Discussion. The study suggests that whilst the press have largely avoided the use of words that press guidance has steered them away from (e.g. “schizo” and “psycho”) that they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend.
    • Registered nurses’ experiences of communicating respect to patients: influences and challenges

      Clucas, Claudine; Chapman, Hazel Margaret; Lovell, Andrew; University of Chester (SAGE Publications, 2019)
      Background: Respectful care is central to ethical codes of practice and optimal patient care, but little is known on influences on and challenges in communicating respect. Research question: What are the intra- and inter-personal influences on nurses’ communication of respect? Research design and participants: Semi-structured interviews with 12 hospital-based United Kingdom registered nurses were analysed using interpretative phenomenological analysis to explore their experiences of communicating respect to patients and associated influences. Ethical considerations: The study was approved by the Institutional ethics board and National Health Service Trust. Findings: Three interconnected superordinate themes were identified: ‘private self: personal attitudes’, ‘outward self: showing respect’ and ‘reputational self: being perceived as respectful’. Respectful communication involved a complex set of influences, including attitudes of respect towards patients, needs and goals, beliefs around the nature of respectful communication, skills and influencing sociocultural factors. A tension between the outward self as intended and perceived presented challenges for nurses’ reputational self as respectful, with negative implications for patient care. Discussion: The study offers an in-depth understanding of intra- and interpersonal influences on communicating respect, and sheds light on challenges involved, helping provide practical insights to support respectful care.
    • The emergence of accelerated resolution therapy for treatment of post-traumatic stress disorder: A review and new subgroup analyses

      Kip, Kevin E.; orcid: 0000-0002-6401-0051; Berumen, Jessica; Zeidan, Amina R.; Hernandez, Diego F.; Finnegan, Alan P. (Wiley, 2019-01-25)
    • Issues of Ageing, Social Class, and Poverty

      Carey, Malcolm (Routledge, 2019-01-18)
      This chapter examines some ethical and political challenges generated by the increasingly complex needs of an ageing society upon social work. It concentrates on the UK as a case study and critically evaluates related age-graded policies and practices relating to social work and care. The chapter includes a discussion of the on-going ethical tensions between social diversity within an ageing society and the shrinking of formal care provision.
    • Sleep hygiene education and children with developmental disabilities:findings from a co-design study

      Sutton, Julie E; Huws, Jaci C; Burton, Christopher R; University of Chester; Bangor University (SAGE publications, 2019-01-17)
      This qualitative study develops a programme theory demonstrating the complexity embedded in sleep hygiene education (SHE) as an intervention to improve sleep problems in children with developmental disabilities. In co-design workshops, eight parents and six sleep practitioners deliberated themes developed from findings of an earlier exploratory study of stakeholder perceptions of SHE. A SHE tool underpinned by programme theory was developed evidenced by midrange theories of change. Analytical themes were developed to explain the programme theory and the complexities of a successful SHE intervention: the need to legitimize children’s sleep problems and consider the nature of customization, knowledge sharing, health expectation and impact of sleep service rationing and gaming strategies on implementation success. Policy and practice implications include a need to raise the public profile of children’s sleep problems and promote parental involvement in intervention implementation. Further research is needed to test out this theory-driven framework for evaluating SHE.
    • The tyranny of ethics? Political challenges and tensions when applying ethical governance to qualitative social work research

      Carey, Malcolm; University of Chester (Taylor & Francis, 2018-11-29)
      This paper examines problems which current ethical governance processes generate for qualitative researchers within social work. It draws upon case studies and critical theory to detail the unpredictable and diverse nature of much social work qualitative research. It argues that too often this research is pitted against a narrow institutional focus placed on positivist-orientated empirical research and income generation. Overtly instrumental interpretations of ethics - often determined by realist and bioethical paradigms - can quickly inhibit the methodological dynamism required to meaningfully capture the complex and non-binary issues which social workers accommodate in their work and subsequent research. Arguments that policy-led, institutional and professional cultures have generated a conservative culture of risk-aversion within the neo-liberal university are also considered.
    • Politicisation or Professionalisation? Exploring divergent aims within UK voluntary sector peer mentoring

      Buck, Gillian; University of Chester (Wiley, 2019)
      Meaningful ‘user involvement’ is an established aim of social work practice, and increasingly, an aspiration of criminal justice, yet there are unique challenges to participatory work within punitive contexts. Drawing upon a study of peer mentoring in the voluntary sector, this article unveils some core tensions related to (ex)service user involvement in criminal justice. Interviews with mentors, mentees, and key stakeholders, along with direct observations of practice, reveal that respondents often see their work as personal-political, emphasising the value of lived expertise and of collective action to address limiting social conditions. Simultaneously, however, mentoring is framed nationally and shaped locally by more established aims to correct, improve, and manage, individual ‘offenders’. There is, therefore, a fundamental tension between processes of politicisation, or coming together to assert a user voice and affect social change; and professionalisation, wherein mentors are co-opted into forms of practice they often critique.
    • Social Work Through Collaborative Autoethnography

      Gant, Valerie; Cheatham, Lisa; DiVito, Hannah; Offei, Ebenezer; Williams, Gemma; Yatosenge, Nathalie; University of Chester (Taylor & Francis, 2019)
      This paper discusses a research project involving 5 MA Social Work Students and 1 member of Social Work Academic Staff. Using narrative and taking a collaborative autoethnographical approach, this project highlights some of the feelings that students articulated following a 70 day placement experience. Findings include anxiety, powerlessness and frustration, together with growing confidence, recognition of their skills and a deeper understanding of the role of ‘self’ in social work. Raising issues of preparedness for practice placement, this paper has implications for both social work practice and social work education. Autoethnography (AE) is both a method of carrying out research and a methodology, specifically a qualitative methodology linked to ethnography and narrative inquiry. AE results in highly personalised narrative accounts of the researcher’s engagement with specific sociocultural contexts in the pursuit of knowing more about a phenomenon. Applying such a methodology to explore collaboratively issues of student lived experience of placement is a new and innovative use of this method.
    • The Perspective of Socioeconomic Inequalities and Infectious Disease in 21st Century

      Massey, Alan; Mabhala, Mzwandile A.; University of Chester (OMICS Group International, 2016-04-20)
      At the turn of the new century, the United Nations set a series of global health goals to be achieved by 2015. Amongst the eight Millennium Development Goals (MDGs), goal six aimed to combat HIV, malaria and other diseases.
    • Art therapy with refugee children: a qualitative study explored through the lens of art therapists and their experiences

      Akthar, Zahra; Lovell, Andrew; University of Chester (Taylor and Francis, 2018-11-09)
      This article sets out to explore the use of art therapy with refugee children, from the perspective of art therapists and their experiences. Three semi-structured interviews were conducted to gain insights by capturing experiences and stories. Using thematic analysis, five themes were identified: (1) giving voice; (2) rebuilding trust, opening wounds; (3) sharing stories, healing pain; (4) exploring identity, discovering new-self; and (5) understanding art therapy. Upon reflection, two key aspects of art therapy were established, these were identified as: (1) providing refugee children with a safe space to heal and discover new-self, and (2) giving refugee children a voice to express and share stories. Despite the last of the five themes (understanding art therapy) being established as a factor that limits the use of art therapy, this has created an avenue for further research. From the findings, it was concluded that art therapy can be a useful form of psychotherapy for refugee children. Art therapy can provide these children with a safe space to heal, and give them a voice to be heard.
    • Sugar sweetened beverage consumption in the early years and implications for type 2 diabetes: A sub-Saharan Africa context

      Audain, Keiron; Levy, Louis; Ellahi, Basma; University of Zambia; Public Health England; University of Chester (Cambridge University Press, 2018)
      This review aims to explore trends of early consumption of sugar-sweetened beverages (SSBs) in Sub-Saharan Africa (SSA), within the context of growing child and adolescent obesity and escalating type-2 diabetes prevalence. We explore efforts to mitigate these, drawing on examples from Africa and elsewhere. SSBs including carbonated drinks and fruit juices, play a contributory role in the development of obesity and associated non-communicable diseases. SSA is an attractive market for beverage companies owing to its rapid economic growth, growing middle class and youthful populations. SSBs already contribute significantly to total sugar and energy consumption in SSA where a plethora of marketing techniques targeted at younger people are utilised to ensure brand recognition and influence purchasing and brand loyalty. Coupled with a general lack of nutrition knowledge or engagement with preventative health, this can lead to frequent consumption of sugary drinks at a young age. Many high and some middle income countries public health efforts address increasing prevalence of obesity and type-2 diabetes by focussing on strategies to encourage reduction in sugar consumption via health policy and public education campaigns. However, similar efforts are not as developed or forthcoming in low-income countries. Health care systems across SSA are ill-prepared to cope with epidemic proportions of non-communicable diseases, particularly when contextualized with the ongoing battle with infectious diseases. We conclude that greater efforts by governments and the nutrition community to educate the public on the health effects of increased and excessive consumption of SSBs are necessary to help address this issue.